Differentiating Viral from Bacterial Pneumonia in Children: The Diagnostic Role of Lung Ultrasound-A Prospective Observational Study

• Published in: Diagnostics (Basel) 2024-02, Vol.14 (5), p.480
• Main Authors: Stoicescu, Emil Robert, Iacob, Roxana, Ilie, Adrian Cosmin, Iacob, Emil Radu, Susa, Septimiu Radu, Ghenciu, Laura Andreea, Constantinescu, Amalia, Cocolea, Daiana Marina, Oancea, Cristian, Manolescu, Diana Luminita
• Format: Article
• Language: English
• Subjects: bacterial; Bacterial infections; Children; COVID-19; Development and progression; Health aspects; Infection; Infection control; Infections; Infectious diseases; Intensive care; lung ultrasound; Medical personnel; Medical research; Medicine, Experimental; Observational studies; Patients; Pediatrics; Pneumonia; Pneumonia in children; Radiation; Severe acute respiratory syndrome coronavirus 2; Software; Tomography; trans-thoracic ultrasound; Ultrasonic imaging; viral; Viral infections
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics14050480

This prospective observational study aimed to investigate the utility of lung ultrasound (LUS) in diagnosing and managing pediatric respiratory infections, specifically focusing on viral, bacterial, and SARS-CoV-2 infections. Conducted over a period of 1 year and 8 months, this research involved 85 pediatric patients (showcasing a median age of 14 months) recruited based on specific criteria, including age, confirmed infection through multiplex PCR tests, and willingness to undergo LUS imaging. This study employed a 12-area scoring system for LUS examinations, utilizing the lung ultrasound score (LUSS) to evaluate lung abnormalities. The PCR examination results reveal diverse respiratory pathogens, with SARS-CoV-2, influenza, and bacterial co-infections being prominent among the cases. As an observational study, this study was not registered in the registry. Distinct LUS patterns associated with different pathogens were identified, showcasing the discriminatory potential of LUS in differentiating between viral and bacterial etiologies. Bacterial infections demonstrated more severe lung involvement, evident in significantly higher LUSS values compared with viral cases ( < 0.0001). The specific abnormalities found in bacterial superinfection can be integrated into diagnostic and management protocols for pediatric respiratory infections. Overall, this research contributes valuable insights into optimizing LUS as a diagnostic tool in pediatric pneumonia, facilitating more informed and tailored healthcare decisions.